Workers' Compensation Products & Services for Small Businesses
EMPLOYERS®, America’s small business insurance specialist®, has been providing cost-effective workers’ compensation insurance for over a century. With our competitive pricing, financial stability and dependability, EMPLOYERS remains focused on keeping America’s small businesses not only working, but working safely. Here are some of the services we offer when you are an EMPLOYERS policyholder:
Loss Control Services
EMPLOYERS offers you a variety of loss control services designed to make your workplace safer and help you better control your workers’ compensation premiums. These services are available to you at no additional cost and can include:
• Loss Control ConnectionSM – A comprehensive risk management and human resource web center that allows you to build a risk management program that is focused on loss prevention in the workplace.
• Risk Evaluation – Our Loss Control Consultants can help you evaluate the effectiveness of your health and safety programs. They can also help train your staff to recognize and eliminate worksite hazards.
• Comprehensive Loss/Cause Analysis – Using a data-driven analytical process to identify loss patterns and trends, our Loss Control Consultants can help you focus on common causes of accidents and injuries in the workplace.
• *Industrial Hygiene – Our Loss Control Consultants can assist you in recognizing, evaluating and controlling risk factors that may lead to injuries caused by harmful chemical substances, hazardous physical agents and biological contaminants.
• *Ergonomic Services – The Loss Control Consultants at EMPLOYERS can help identify risk factors associated with musculoskeletal disorders (MSDs) in the workplace and how to control them.
*A consultation with a Loss Control Consultant is required before the services listed above will be provided.
Fraud costs everyone money. The EMPLOYERS Fraud Investigations Department operates a comprehensive Anti-Fraud Program that discourages individuals from attempting to defraud EMPLOYERS and its policyholders. The Fraud Investigations Department also aggressively pursues criminal prosecution of those who cannot be deterred.
• Cases of potential fraud investigated by our Fraud Investigations Unit and referred to law enforcement have resulted in more than 185 criminal complaints and 100 convictions since 2003.
• The Fraud Investigations Department has recovered tens of millions of dollars since 2003, helping to protect incurred loss amounts.
• The investigation of criminal fraud is integrated into the basic claims investigation functions. Our in-house Fraud Prevention Specialists review claims for potential fraud and work to recover the monies paid because of that fraud.
In addition, our Anti-Fraud Program offers many advantages, including the following:
• Formal anti-fraud training on a continuing basis to all staff members who deal with claims files or insurance policies
• EMPLOYERS anti-fraud materials and webinar training modules available on www.employers.com
• An e-mail address and “Fraud Hotline” that are available 24 hours per day, seven days a week (including holidays), for the reporting of suspected workers’ compensation fraud
The claims professionals at EMPLOYERS are able to provide high quality and efficient claims management services by working closely with your injured worker, you and our network physician(s). Specifically, we offer the following services:
• A Dedicated Claims Reporting Center – enabling 24/7, multilingual claims reporting by phone or online.
• Dedicated Claims Specialists – who help ensure accountability, consistency and reliability of the claims process. Our policyholders have access to claims specialists who know and understand the intricacies of claims management.
• A Specialized Subrogation Unit – staffed with adjusters who have a strong liability background through which we aggressively pursue recovery from any liable third-party in order to reduce overall claims costs.
Managed Care Services
EMPLOYERS Managed Care Services team works side-by-side with healthcare providers, expert physician advisors, nurses, and other experienced care management staff to promote quality, cost-appropriate, and timely care. Below are just a few of the managed care services EMPLOYERS provides:
• Medical care management by nurses and other healthcare professionals
• Utilization review to determine whether specific care is medically necessary and appropriate for an injured employee
• A Medical Provider Network to help injured employees receive the medical care they need, while minimizing the cost to policyholders
• Pharmacy benefits that provide an extensive network of retail pharmacies to meet the needs of injured workers
• Collaboration with claims adjusters to facilitate early return to work for injured employees
• A physician advisor consultation to help deliver timely, appropriate and cost-effective care for injured workers